The Associate Degree Nursing program of the Dallas County Community College System in cooperation with
Methodist Health System offers the Associate Degree Nursing program to Methodist Health System employees at member hospitals throughout the Dallas-Fort Worth area via a distance learning opportunity. The 72-credit hour curriculum leads to an Associate of Applied Science Degree and is accredited by the National League for Nursing
Accreditation Commission and the Texas Board of Nursing.
NOTE: An FBI background check and fingerprinting is required for registration and formal entrance to the program and is conducted after a student has applied and been accepted to the program.
Acceptance to the Associate Degree Nursing program at Methodist Health System is by a competitive ranking process for selection based on a point’s award system for designated criteria and meeting specific eligibility guidelines as determined by Methodist Health System.
This information packet contains specific application guidelines and requirements. By submitting an application packet, an individual verifies that they have 1) read the packet thoroughly, 2) obtained all necessary documents from designated website addresses, and 3) understood the policies and procedures for application and acceptance to the program.
EQUAL EDUCATIONAL OPPORTUNITY
Educational opportunities are offered by the Dallas County Community College System without regard to race, color, age, national origin, religion, sex, disability, or sexual orientation.
APPLICATION ELIGIBILITY GUIDELINES
To be considered for the Associate Degree Nursing program at Methodist Health System, an employee must first meet the following criteria:
 Must be employed by Methodist Health System for a minimum of 6 months or a volunteer for a minimum of 6 months, plus 100 hours of volunteer time completed or by an immediate family member (spouse, child, parent or sibling) of a Methodist Health System employee.
 Have had no formal disciplinary actions in the last 6 months.
In addition, the employee must complete the following steps for application as determined by the El Centro
College Associate Degree Nursing program:
 Application and current admission to a Dallas County Community College District (DCCCD) college.
 Attendance at a nursing program information session held at one of the Methodist Hospital sites is encouraged.

Completion of the five primary prerequisite courses with a minimum cumulative grade point average
(GPA) of 2.5 on those courses.
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Associate Degree Nursing (MHS) Revised 06/01/12

B.

Completion of all secondary prerequisite courses (SCIT 1408 or BIOL 2402, BIOL 2420, PSYC 2314, and SPCH 1311) with a minimum grade of “C” in each course.
 Completion of designated sections of the HESI A
2
Test with a minimum score of 70% on each of the required sections.
 Submission of complete application materials to the El Centro College Health Occupations Admissions
Office as outlined in this information packet.
A.
APPLICATION PROCEDURE
General Admission Requirements to the College
Applicants to the Associate Degree Nursing program must meet college admission requirements in the
Dallas County Community College District as outlined in the official college catalog at http://www.ElCentroCollege.edu
. Applicants must have earned either a high school diploma or General
Education Diploma (GED) in addition to complying with Texas Success Initiative (TSI) requirements.
Students should consult the college counseling office to determine their TSI status prior to application to a
Health Occupations program.
Official College Transcripts
Prior to application to a health occupations program, potential applicants must have submitted all of their official transcripts to the Registrar/Admissions Office at one of the seven Dallas County
Community College District campuses.
The transcripts must be current with the print date no earlier than three years of the applicant’s anticipated admission to a health occupations program. If the official transcripts have not been submitted, the individual’s application to a health occupations program will be voided.
Initial Advisement
Students who are beginning college for the first time or who need assistance with placement testing, TSI issues, and/or registration for prerequisite courses must visit with an academic advisor in the College
Counseling Center as their first step toward future application to a health occupations program The student who has not completed college coursework should request a general Associate Degree plan from the Counseling Center as a starting point toward application to a health occupations program.
Program Information Sessions at Methodist Health System Sites
Information sessions specifically for potential applicants to the Associate Degree Nursing program at
Methodist Health System are currently held at various Methodist System sites throughout the year. For current dates and times of the information sessions, please contact Kimberly Griffith, MSN, RN, Education
Specialist II, Methodist Health System, 214-947-1548. The information schedules will also be posted at
Methodist Health System sites.
Beginning Fall 2012, program information sessions will be available online at the Health Occupations
Admissions webpage. Monthly “Question and Answer” sessions will be held at the El Centro College
Center for Allied Health and Nursing (Paramount Building). These Q&A sessions will be open only for individuals who have viewed the online information sessions.
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D.
C. Program Prerequisite Courses
Applicants must complete the following five primary prerequisite courses with a minimum cumulative grade point average of 2.5 or higher on these specific courses in order to submit an application to the nursing program:
SCIT 1407* Applied Human Anatomy & Physiology I OR
BIOL 2401 Anatomy & Physiology I
ENGL 1301 Composition I
Credit Hrs.
4
3
MATH 1314** College Algebra
PSYC 2301 Introduction to Psychology
HPRS 1204+ Basic Health Professions Skills I
3
3
2
15
In addition, applicants to the Associate Degree Nursing program at Methodist Health System must have completed the secondary prerequisite courses listed below with a minimum grade of “C” or higher prior to applying to the program:
Credit Hrs.
4 SCIT 1408* Applied Human Anatomy & Physiology II OR
BIOL 2402 Anatomy & Physiology II
BIOL 2420* General Microbiology
PSYC 2314 Developmental Psychology
SPCH 1311++ Introduction to Speech Communications
4
3
3
14

Science courses including SCIT 1407/BIOL 2401, SCIT 1408/BIOL2402, and BIOL 2420 must be completed less than 5 years prior to program application. SCIT 1407 is not offered at Richland
College of the DCCCD. BIOL 1406 is the prerequisite for BIOL 2401.
** MATH 1414 – College Algebra will also be recognized as the math prerequisite course; however, it will be calculated as a three credit hour course for ranking purposes only. The math prerequisite no longer has a 5-year time limit.
+ HPRS 1204 is offered at the El Centro and Northlake College campuses only and should be completed no earlier than three years prior to their anticipated admission to the Associate Degree Nursing program.
For example, if completed in Fall 2011, the course would be valid for application up to and including
Fall 2014; if completed in Spring 2011 or Summer 2011, the course would be valid for application up to and including Spring 2014.
++ Although SPCH 1311 is the preferred course, SPCH 1315 – Fundamentals of Public Speaking is also accepted.
Evaluation of Previous Coursework
To insure the transferability of previous coursework completed at colleges and universities other than
Dallas County Community College District campuses, potential applicants to health occupations programs should have their coursework evaluated by the Health Occupations Admissions Office three to six months prior to the application deadline for their program of choice. This procedure is especially important for students with coursework from colleges and universities outside the state of Texas.
Associate Degree Nursing (MHS)
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Transcripts and accompanying course descriptions will first be evaluated by the Health Occupations
Admissions Office and, if necessary, be reviewed by respective college faculty for that course discipline.
When all courses have been reviewed, an Educational Plan will be prepared for the student. The
Educational Plan is accepted as a preliminary “degree plan” for student advisement purposes.
Educational Plans are usually completed within 10-14 working days. The evaluation process is not completed during individual appointments or on an “as you wait” basis.
During peak times such as registration or after the close of the semester when faculty are unavailable, an evaluation may take as long as 30 days for review. Therefore, it is to the applicant’s advantage to request the Educational Plan at their earliest convenience well in advance of anticipated application to the program.
The El Centro College Health Occupations Admissions Office and the Health and Legal Studies Division reserves the right to accept or reject any coursework completed outside the DCCCD presented for transfer evaluation toward Health Occupations programs.
For more information on requesting evaluation of your previous coursework and the Educational Plan, download the guidelines and Request for Educational Plan form at the following link: http://www.ElCentroCollege.edu/HealthOccAdmissions .
Five-Year Time Limit on Science coursework
All science coursework (anatomy/physiology and microbiology) must have been completed less than five years prior to application to a Health Occupations program. For example, an SCIT 1407 course completed in Fall 2008 would be valid only up to application for the Fall 2013 semester. If an individual has current experience utilizing their related science knowledge or has completed advanced courses in a related science area, the student may petition for a waiver of the time limit through the Health Occupations
Admissions Office as a separate review or in conjunction with an educational plan request.
NOTE: In order for a science course taken outside the DCCCD to be considered for a five-year time limit waiver, the course must first be approved for transferability. Information on the five-year time limit waiver is included with the Request for Educational Plan guidelines at the following link: http://www.ElCentroCollege.edu/HealthOccAdmissions .
Coursework from Foreign Universities
Only courses such as college algebra, anatomy/physiology, and microbiology may be considered for transfer to Health Occupations programs from colleges or universities outside the United States. No other courses will be considered.
Science courses must be within the five-year time limit.
For more information regarding the evaluation of foreign coursework for transfer credit, see the following link: http://www.ElCentroCollege.edu/HealthOccAdmissions .
Credit by Examination, CLEP, and Advanced Placement Credit
Credit through CLEP, High School Advanced Placement Exams and Credit by Examination may be awarded for a limited number of courses toward Health Occupations programs.
Advanced Placement (“AP”) credit for ENGL 1301 and MATH 1314 is acceptable if the credit appears on a college transcript as ENGL 1301 and MATH 1314 equivalency. A letter grade is not awarded for “AP” credit.
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NOTE: An applicant to the Associate Degree Nursing program may present credit by exam, CLEP, or “AP” credit for only one of the five prerequisite courses and one support course. Credit will be acknowledged but not calculated with the grade point average.
Detailed information regarding Advanced Placement, CLEP, and Credit by Examination can be found at http://www.ElCentroCollege.edu/HealthOccAdmissions .
The HESI A
2
test is a timed, computerized test which is usually completed in 3-4 hours. In addition to completing the five prerequisites courses, applicants to the Associate Degree Nursing program must also earn a minimum score of 70 of higher on the following sections of the HESI A
2
test: Reading
Comprehension, Grammar, Vocabulary/General Knowledge, Math, and Anatomy/Physiology.
Students must also complete the Learning Styles and Personality Profile sections and submit those results with their application materials. The Learning Styles and Personality Profile sections are not graded.
HESI A
2
scores are considered in the point’s award ranking process. Scores on the math and anatomy/physiology sections are considered separately. Scores on the Reading Comprehension, Grammar, and Vocabulary/General Knowledge are combined and the average score (referred to as the “English” score in the sample ranking table on page seven) is considered for points.
The following is an example of points awarded for a sample applicant’s HESI A
2
scores:
HESI A
2
section Score Points Awarded
Math
Anatomy/Physiology
Grammar 88
94 3
96 4
Vocabulary/General Knowledge 92
Reading Comprehension 87.23
267.23 ÷ 3 = 89.08
(“English” score) 2
Please note the following important information regarding the HESI A
2
:

Test scores are valid for two years from the date of testing to the date of anticipated entrance to the program.

Applicants may take the HESI A
2
at any approved testing site including the assessment centers at
El Centro, Brookhaven, Mountain View, and Northlake College campuses. The approximate cost of the HESI test at DCCCD campuses is $35.00.

Applicants are responsible for securing their own testing appointment at the location of their choice.
The procedure for making testing appointments and payment varies among testing sites.
Applicants are responsible for submitting their score sheet with their nursing application materials.

The HESI A
2
Study Guide is available at various bookstores including the Follett Bookstores at the El Centro and Northlake campuses.

A HESI A
2
Prep course is periodically offered by the El Centro College Continuing Education
Division. Contact that office at 214-860-2147 for dates and times of the prep course.
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F.

There is no limit on the number of times an applicant may take the HESI A
2
test for application to the Associate Degree Nursing Program.
If the applicant desires to retake the
HESI A
2
, ALL FIVE SECTIONS must be retaken. Only one score sheet should be submitted with scores of 70 or higher on each of the five required sections. Scores on individual test sections which are printed on separate score sheets cannot be combined. If more than one score sheet is submitted, the scores from the latest HESI testing attempt will be the scores of record. It is not necessary to repeat the Learning Styles and Personality Profile sections on retests. The printout of these sections can be submitted from one testing attempt.

Before retesting, the applicant is encouraged to review the study guide and/or enroll in the HESI
A
2
prep course to prepare for the retest opportunity.
More information on the HESI A
2
and the process for scheduling a testing appointment to take the HESI A
2 at the El Centro campus is available at: http://www.ElCentroCollege.edu/HealthOccAdmissions
Application Packet Submission
Read the following instructions carefully. Applicants must submit specific application materials to the El
Centro College Health Occupations Admissions Office and specific application materials to the Methodist
Health System Education Office. Please refer to the following guidelines and insure that the appropriate application materials are submitted to the correct location.
Application materials to be submitted to the El Centro College Health Occupations Admissions Office
Applicants must submit a complete application packet to the Health Occupations Admissions Office at El
Centro College on or before the application filing deadline. Incomplete packets will be returned to the applicant.
Complete application packets may be presented in person at the Health Occupations Admissions
Office during regular hours of operation or submitted in the drop box adjacent to the office door.
Mailed application packets must be postmarked no later than an application filing deadline date.
NOTE: In the event that the last day of a filing period falls on a holiday or a Sunday when the campus is closed or when the post office does not postmark mail, complete application packets may be presented to the El Centro College Health Occupations Admissions Office in person by 5:00 p.m. the next regular business day.
To submit your application by mail, address your envelope to:
RonChelle Kelly, MHS Nursing
Health Occupations Admissions Office
El Centro College
801 Main Street
Dallas, Texas 75202-3604
To submit your application in person, bring your envelope to:
RonChelle Kelly, MHS Nursing
Health Occupations Admissions Office Room P-101
Center for Allied Health & Nursing (Paramount Building)
301 North Market Street
Dallas TX 75202
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The Associate Degree Nursing program application packet must include the following items to be considered complete and valid:
1. A completed Associate Degree Nursing Program Application form and the initialed and signed
Statement of Student’s Responsibility form (both included in this information packet).
2. A for each course taken outside the Dallas County Community
College District which applies to the nursing curriculum (prerequisite courses and/or general studies courses) and for which the student seeks transfer credit.
Course descriptions may be photocopies or printouts from online catalogs. The course numbers on catalog course descriptions must match those on the transcript. Course descriptions should be marked on the photocopy. Do not mark or highlight courses on official transcripts.
Course descriptions are not required for courses completed at a DCCCD campus.
HESI A
2
score sheet indicating achievement of a minimum score of 70 or higher on each of the five required sections and the Personality Profile and Learning Style results.
4.
The completed Physical Examination and Immunizations Record form. Applicants are responsible for obtaining the physical form and immunization guidelines from the following link: www.ElCentroCollege.edu/Programs/HealthOccAdmissions.
See also item 5 under the General
Information section on page 13 of this packet. NOTE: An additional copy of your immunization records and TB screen is also submitted to Methodist Health System as indicated below.
5.
A photocopy of the applicant’s current “Healthcare Provider” level CPR card.
The expiration date of the card must not occur before the end of the first semester of potential entry to a Health Occupations program. See also item 6 under the General Information section on page 13 of this information packet. NOTE: An additional copy of your CPR card is also submitted to
Methodist Health System as indicated below.
NOTE: Applicants are solely responsible for ensuring that their current official transcripts from
ALL PREVIOUSLY ATTENDED COLLEGES AND UNIVERSITIES (excluding DCCCD campuses) are submitted to a Registrar/Admissions Office at a DCCCD campus prior to applying to an El Centro College health occupations program. Official transcripts must have a print date no earlier than three years of anticipated entry to a health occupations program.
Submitting incomplete application materials (including physical exam, immunizations, etc.) will disqualify the application and the student will not be considered further in the application process. Students are advised to retain a photocopy of all materials submitted as their application packet.
ONCE AN APPLICATION PACKET IS SUBMITTED TO THE HEALTH OCCUPATIONS
ADMISSIONS OFFICE, IT CANNOT BE RETRIEVED BY THE APPLICANT UNTIL AFTER
THE FILING PERIOD ENDS.
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Documentation to be Submitted to Methodist Health System
Photocopies of all documentation listed in Section F, items 1-5 above which were sent to the El Centro
College Health Occupations Admissions Office must also be submitted to the Methodist Dallas Medical
Center Department of Education office:
1.
Profile Form (found in this packet)
2.
HESI A
2
score sheet
3.
El Centro College Health Occupations Physical Exam form
4.
Immunization records indicated below (documentation of positive titers accepted for those indicated by an asterisk *):

Tuberculosis Screening – Intradermal PPD (Mantoux) within the past 12 months; if previously positive, a chest x-ray is required within the last 12 months.

Measles* – Two (2) doses of measles vaccine is required either in a separate injection or in combination with mumps and rubella (“MMR”).

Mumps* – One (1) dose of mumps vaccine is required either in separate injection or in combination with measles and rubella (“MMR”).

Rubella* – One (1) dose of mumps vaccine is required either in a separate injection or in combination with measles and mumps (“MMR”).

Tetanus/diphtheria/pertussis – One (1) dose of Tdap is required within the past ten (10) years.

Varicella (chickenpox)* - Two (2) doses of varicella vaccine are required (history of disease statement is not accepted).

Flu – A current flu injection is required each year.

Hepatitis B series* – Three (3) doses of Hepatitis B vaccine are required per the timetable below:
Initial dose
2 nd
dose one month after the initial dose
3 rd
dose five months after the second dose
NOTE: If an individual has received the first two Hepatitis B injections with the third and final injection scheduled after an application filing deadline, the individual may submit their application materials, including the physical exam form and all other immunizations provided the third injection is scheduled to be received
BEFORE the first class day of the program. Documentation of the last injection must be forwarded immediately to both MHS and El Centro College
Health Occupations Admissions Office.
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
Meningitis vaccine - New state of Texas immunization requirement for bacterial meningitis, beginning Spring 2012 semester. You must provide DCCCD with proof of meningitis vaccination if: o You are enrolling for the first time as a credit student. o You are returning after a semester break in enrollment. (If you were enrolled during
Fall 2012, you do not need to provide proof of vaccination.) o You are transferring to DCCCD from another college or university.
Exceptions to the new law: You do not need to provide proof of meningitis vaccination for the Spring 2013 semester if you are 30 years of age or older (by the first day of the semester in which you are enrolled). More information is available online at http://www.elcentrocollege.edu/dual-credit/proof-meningitis .

Photocopy of your “Healthcare Provider” CPR card.
Submit the above documentation to the following contact person at Methodist Health System:
Methodist Health System
G. Application Filing Period
There are two application filing periods per year for the Associate Degree Nursing program at Methodist
Health System:
Official application filing period for Fall semester (late August) admission:
January 1 – May 20
Notification letters are mailed to students by July 1 st
.
Official application filing period for Spring semester (mid January) admission:
August 1 – October 20
Notification letters are mailed to students by December 1 st
.
Late Application Guidelines
In the rare event that all individuals on the ranked list for a specific application filing period are accepted and space still remains in that nursing class, late applications will be considered. Application materials
MUST be submitted to the El Centro College Health Occupations Admissions Office in person during regular office hours or via overnight mail.
Late filing for Fall semester admission (only if necessary): May 21 – July 15
Late filing for Spring semester admission (only if necessary): October 21 – December 15
Potential applicants applying during a late application filing period will be notified of their acceptance status via phone and an official packet from El Centro College will be mailed to you.
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H. Initial Ranking Procedure
Applicants are ranked for acceptance selection via a point award system*. Point award totals for applicants may range from a minimum of 5 points to a maximum of 32 points on the designated criteria below:
POINT AWARD CRITERIA POTENTIAL POINTS PER CRITERIA
Primary Prerequisite Course Cumulative GPA (2.5 minimum required)
2.50 – 2.99 = 3 points
5 points
Secondary Prerequisite Courses Cumulative GPA (“C” or higher in each) *
2.00 – 2.49 = 2 points
5 points
Humanities Elective completed with a minimum grade of “C”
1 – 4 credit hours = 1 point
HESI A
2
Test – Points awarded for each of the following sections:
Math, Anatomy/Physiology, and combined “English” sections:
70 – 74
75 – 79
=
=
0 points
1 points
1 point
12 points
80 – 89
90 – 95
96 – 100
=
=
=
2 points
3 points
4 points
Specific coursework toward the UTA Professional Nursing Pathways
RN to BSN transition program – 1 point per course below: 9 points
MATH 2342 – Statistics
HIST 1301 – US History I
HIST 1302 – US History II
GOVT 2301 – Government I (US)
GOVT 2302 – Government II (State & Local)
SOCI 1301 – Intro to Sociology
ENGL 1302 – Composition II
ENGL 2311 – Technical Writing
2000 or above ENGL literature course
NOTE: The above courses are only considered for possible points in the ranking process. This consideration does not guarantee transferability of the courses toward the UTA transition program.
UTA must ultimately verify transferability of these courses.
MAXIMUM TOTAL POINTS 32 points
NOTE: In the event of two or more applicants with the same point award total, the cumulative score on all five required sections of the HESI A
2
will be used to break the tie.
Applicants to the Associate Degree Nursing program at Methodist Health System must have completed 13 credit hours of the general education support courses (SCIT 1408/BIOL 2402, BIOL 2420, PSYC 2314, and SPCH 1311) in order to apply to the program.
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Associate Degree Nursing (MHS) Revised 06/01/12

Applicant #1
Applicant #2
Applicant #3
Applicant #4
Applicant #5
Applicant #6
Cumulative
GPA on
4 Primary
Prerequisite
Courses
(Max. 5 pts.)
The table below illustrates the ranking process for a sample group of applicants:
EXAMPLE OF POINT AWARD RANKING PROCESS
Cumulative
GPA on
4 Secondary
Prerequisite
Courses
(Max. 5 pts.)
3.77 = 5 pts 5 pts.
Support Course
Credit Hours
(Max. 1 pt.)
HESI A
2
Scores on English*,
Math, and
Anatomy/Physiology
(Max. 12 pts.)
Other courses toward UTA
Professional
Pathways BSN
Articulation
(Max 9 pts.)
9 courses from the list on page 11
Total Points
(Max.32 pts.)
32
3.54 = 5 pts.
4 pts.
4.00 = 5 pts.
4 pts.
3 cr hrs =
3 cr hrs =
1 pt.
1 pt.
English 97.26 = 4 pts.
Math 98 = 4 pts
A/P 96 = 4 pts.
TOTAL HESI PTS 12 pts.
English 94.89 = 3 pts.
Math 96 = 4 pts.
A/P 97
TOTAL HESI PTS 11pts.
3 cr hrs = 1 pt.
English
Math 99 = 4 pts.
7 courses
6 courses
28
26
Cumulative Scores on all five required sections of
HESI A
2
(tiebreaker)
455.26
458.89
451.74
3.31 = 4 pts.
4 pts.
2.92 = 3 pts.
3.25 = 4 pts.
4.00 = 5 pts.
5 pts.
TOTAL HESI PTS 10 pts.
0 cr hrs = 0 pts.
pts.
A/P 96
TOTAL HESI PTS 11 pts.
3 cr hrs = 1 pts.
pts.
A/P 90
TOTAL HESI PTS 5 pts.
3 cr hrs = 1 pts.
pts.
4 courses
5 courses
2 courses
23
18
18
468.74
422.26
415.68
TOTAL HESI PTS 5 pts.
* “English” score is derived from averaging the Reading Comprehension, Grammar, and Vocabulary/General
Knowledge sections of the HESI A
2
.
The shaded columns reflect the total point award calculation. You will note that no single ranking criterion determines competitiveness in the applicant pool. All four ranking criteria (cumulative primary prerequisite course GPA, cumulative secondary prerequisite course GPA, humanities elective credit hours completed with a grade of “C” or higher, the three designated HESI A
2
scores, and additional courses toward the UTA Professional Nursing Partnership transition program factor into the point award ranking process.
Applicants may improve their points ranking by: 1) repeating one or more of the five prerequisite courses to earn a higher primary prerequisite GPA (the last grade earned will be the grade of record), 2) repeating one or more of the 4 secondary prerequisite courses to earn a higher secondary prerequisite GPA,
3) completing the required humanities elective course, 4) repeating the HESI A
2
to earn a higher score in each section (all five sections of the HESI A2 must be repeated in a retesting attempt), or 5) completion one or more of the additional courses toward the UTA Professional Nursing Pathways transition program to subsequently earn additional points. NOTE: The decision to repeat a successfully completed course (any primary prerequisite or secondary prerequisite course completed with a grade of “C” or higher) in order to improve an applicant’s competitiveness in the ranking process rests solely with the applicant.
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I. Review of Ranked Applicants and Final Selection by Methodist Health System
The El Centro College Health Occupations Admissions Office generates a ranked list of applicants received during an official filing period and forwards the list to Methodist Health System for further screening. (See
Section H for ranking procedure.) The Methodist Health System screening process may include a review of longevity with the Methodist Health facility and review of an individual’s work record with the facility in addition to other criteria.
Methodist Health System will then make the final selection for the nursing class from the ranked list of applicants and forward the names of those individuals to the El Centro College Health Occupations
Admissions Office which notifies the students of acceptance to the program. Individuals who are not accepted also receive a notification letter.
Notification Letters
A student who applies during an official filing period and who receives an acceptance letter is required to return a confirmation form within a specified timeframe to verify their intent to accept a space in the class.
Applications submitted during an official filing period are not “held over” to the next official filing period.
Students who are not selected for admission the semester for which they apply or students who decline their acceptance for that semester must retrieve and resubmit their application packet by a specified date to reapply during the next application filing period.
NOTE: Applications submitted during an official filing period are not “held over” to the next official filing period. Students who are not selected for admission the semester for which they apply or students who decline their acceptance for that semester must retrieve and resubmit their application packet during the next filing period to be considered for the next admission opportunity.
st
Visit the Associate Degree Nursing Program webpage at http://www.ElCentroCollege.edu/Program/Health/ADN
Health Occupations webpage: http://www.ElCentroCollege.edu/HealthCareers
Health Occupations Admissions Office webpage: http://www.ElCentroCollege.edu/HealthOccAdmissions
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CURRICULUM OVERVIEW – ASSOCIATE DEGREE NURSING PROGRAM #
SCIT 1407* Applied Human Anatomy & Physiology I OR
BIOL 2401 Anatomy & Physiology I
ENGL 1301 Composition I
MATH 1314** College Algebra
HPRS 1204+ Basic Health Professions Skills I
PSYC 2301 Introduction to Psychology
3 3
3 0
3 0
1 3
3 0
0
Cont Cr
Hrs
96 4
0
0
0
48
48
64
3
3
2
0 48 3
15
SEMESTER I – First Year
RNSG 1423 Introduction to Professional Nursing
RNSG 1460 Clinical – Nursing (RN Training)
RNSG 1209 Introduction to Nursing
SCIT 1408* Applied Human Anatomy & Physiology II OR
BIOL 2402* Anatomy & Physiology II
PSYC 2314 Developmental Psychology
4
0
0
3
3
0
0
2
3
0
0
12
0
0
0
64
192
96
96
48
12
4
4
2
4
3
SEMESTER II – First Year
RNSG 2504 Care of Client w/ Common Health Needs
RNSG 1461 Clinical – Nursing (RN Training)
BIOL 2420 General Microbiology
SPCH 1311+ Introduction to Speech Communications
5
0
3
3
0
0
3
0
0
12
0
0
80
192
112
48
12
5
4
4
3
SEMESTER III – Second Year
RNSG 2514 Care of Clients w/ Complex Health Needs
RNSG 2460 Clinical – Nursing (RN Training)
5
0
0
0
0
12
80
192
5
4
3 0 0 48 3
12
SEMESTER IV – Second Year
RNSG 2535 Integrated Client Care Management
RNSG 2562 Clinical – Nursing (RN Training)
RNSG 2221 Management of Client Care
5
0
2
0
0
0
0
15
0
80
240
32
15
5
5
2
# The above curriculum outline is the official Associate Degree Nursing Curriculum and does not reflect the primary and secondary prerequisite course requirements for Methodist Health System applicants.
* BIOL 1408 recommended prior to SCIT 1407 if no previous high school biology. BIOL 1406 is a required prerequisite for BIOL 2401. Science courses must have been completed less than five years prior to program application.
** MATH 1414 also accepted for MATH 1314.
+ HPRS 1204 must be completed no earlier than three (3) years prior to anticipated entry to the nursing program.
++ Although SPCH 1311 is the preferred course, SPCH 1315 – Fundamentals of Public Speaking is also accepted.
+++ Humanities elective must be chosen from the approved list on the official Associate Degree Nursing degree plan.
Suggested courses include: ARTS 1301, DANC 2303, DRAM 1310, HUMA 1315, MUSI 1306, PHIL 1301, PHIL
1304, selected ENGL literature courses at the 2000 level or higher, sophomore level foreign languages such as
SPAN 2311.
A minimum grade of “C” is required in all courses. Support courses may be completed before but not after semester indicated.
RNSG 2535 – Integrated Client Care Management; RNSG 2562 – Clinical Nursing; and an Exit Program Competency
Exam represent the Capstone experience for the Associate Degree Nursing Program.
Associate Degree Nursing (MHS)
13
Revised 06/01/12

GENERAL INFORMATION
1. The Associate Degree Nursing Program at Methodist Health System accepts two classes per year in the Fall and Spring semesters. Each class is composed of approximately 20 students each semester. The El Centro
College Health & Legal Studies Division and Methodist Health System reserve the right to make changes in program enrollment capacity. Methodist Health System is solely responsible for assigning accepted students to a specific Methodist Health System facility for their clinical experience.
2. The Associate Degree Nursing program is completed in four, 16-week academic semesters. Each course involves 16-20 hours per week of class, lab, and clinical experience with an additional 2-3 hours of studying and preparation time for each hour of class and clinical experience. Clinical experiences in area hospitals are determined by a lottery system and may involve both daytime and evening hours. The high demand on a student’s time will not allow for full-time employment while enrolled in the nursing program.
3. Students enrolled in the Associate Degree Nursing program must be physically able to care for patients that will involve lifting an adult patient of average size, moving, bathing, and transferring patients into and out of bed. Students will be on their feet for at least eight hours each clinical day. Students must be able to read fine print for medication administration purposes and be able to hear heart and breath sounds. Manual dexterity is required for skills such as starting IV’s, administering injections, etc. In the event that a student has a medical condition which may compromise their ability to care for patients, a medical release from their physician may be required. Students will be exposed to infectious diseases.
4. Students must comply with class and clinical attendance requirements according to nursing student handbook guidelines which are published annually. Students who are absent from clinical for physical or mental illness, surgery or pregnancy reasons must present a written release from a physician before being allowed to return to the clinical setting. Students who are anticipating surgery or delivery of a baby during an academic semester are advised to wait until the following semester to apply to the nursing program.
5. All nursing applicants must comply with physical examination and immunization requirements and submit the documentation with application materials. Physical examination forms and immunization records become the property of the Health Occupations Admissions Office and will not be returned or photocopied for the student; therefore, the student must retain a copy of these documents for their personal records.
Immunization requirements include: measles (2 doses), mumps, rubella, combination tetanus/diphtheria/pertussis (Tdap), varicella (2 doses), flu, Hepatitis B series (3 injections), and a tuberculosis screening.
The Physical Examination Form and immunization requirements guidelines are available at: http://www.ElCentroCollege.edu/HealthOccAdmissions .
6. All nursing applicants must be certified in cardiopulmonary resuscitation (CPR) at the “Healthcare Provider” level as designated by the American Heart Association. A copy of the CPR card is submitted with nursing application materials with an additional copy submitted to Methodist Health System. The CPR card must not expire before the anticipated date of entry to the program or during a semester when enrolled in the program. CPR classes are available through the El Centro College Continuing Education Division, the
American Heart Association, American Red Cross, various hospitals, independent instructors, etc. Online
CPR certification classes are not valid for application to health occupations programs.
14
Associate Degree Nursing (MHS) Revised 06/01/12

7. Clinical opportunities may be limited for students without Social Security numbers. If accepted to the program, a student must contact the El Centro College International Center Office (Room CM-60, telephone
214-860-2090) regarding eligibility to apply for a Social Security number before graduation from the program. A Social Security number is required to be sponsored by MHS for the nursing program.
8. Many of the nursing prerequisite and support courses are offered online. Students without prior experience with Internet courses should take the Readiness for Education at a Distance Indicator (READI) test to see if they are a good candidate for online learning. Go to http://dtc.smartermeasure.com/ and log in as a New
User. The current User Name is choose el centro and the Password is student .
9. Criminal Background Check / Drug Screening
All students enrolled in Health Occupations programs are required by the Dallas/Fort Worth Hospital Council member facilities to undergo a criminal background check and drug testing prior to beginning their clinical experience. Students are responsible for all charges incurred (approximately $86.00) for these screenings.
This procedure is conducted after a student has been accepted to their respective program.
Results of these screenings are forwarded to the El Centro College Health/Legal Studies for review and verification that a student is eligible to attend clinical rotation. All background check and drug screening results become the property of the Health and Legal Studies Division and will not be released to the student or any other third party.
A clinical agency reserves the right to remove a student from the facility for suspicion of substance use or abuse including alcohol. The clinical agency reserves the right to request that a student submit to a repeat drug screening at the student’s expense on the same day that the student is removed from the clinical facility.
Failure to comply will result in the student’s immediate expulsion from the clinical facility. Furthermore, regardless of testing or testing results, a clinical agency reserves the right to expel a student from their facility.
NOTE: Should a student who has been accepted to a Health Occupations program be prohibited from attending a clinical rotation experience due to findings of a criminal background check and/or drug screening, the student may be dismissed from the Health Occupations program.
More information regarding the Criminal Background Check and Drug Screening procedure is found at: http://www.ElCentroCollege.edu/HealthOccAdmissions .
10. Students are responsible for their own transportation arrangements to campus and to their assigned health care facilities for clinical experience.
11. Students who are enrolled at the El Centro campus in 6 credit hours or more during a fall or spring semester and 3 credit hours or more during a summer semester are entitled to a free DART train/bus pass for that semester. DART passes are available at the Cashier’s office two weeks after the semester begins.
12. Individuals who were first-time college freshman students in Fall 2007 or after are subject to the guidelines of section 51.907 of the Texas Education Code which prohibits a student from dropping more than six (6) college level credit courses during their entire undergraduate career. For more information on the 6 Drop rule, see the official college catalog online at: https://www1.dcccd.edu/catalog/ss/oep/dw.cfm?use_nav=acad_info&loc=ECC
15
Associate Degree Nursing (MHS) Revised 06/01/12

13. Students are required to answer certain questions on the Texas Board of Nursing application for Registration by Examination to become licensed as a Registered Nurse. These questions are in regard to criminal convictions, mental illness or chemical dependency, or prior disciplinary action by a licensing authority for nurses. Students answering “yes” to those questions must submit the required documents with an explanation to the Texas Board of Nursing at least eighteen (18) months prior to graduation. The Texas Board of Nursing will consider these documents and reach a decision regarding eligibility to write the licensing examination.
An applicant may request a Declaratory Order (a decision by the Texas Board of Nursing regarding an applicant’s eligibility to take the licensing exam) prior to entering a program of nursing. More information on this issue is found on the Texas Board of Nursing website at www.bon.state.tx.us/Exam-eligibility.htm
. For further information, contact Ms. Joan Becker, Director of Nursing at 972-860-5098.
NOTE: A Social Security number is required to apply to take the NCLEX-RN licensure examination.
14. All applicants to the Associate Degree Nursing program must show proof of personal healthcare insurance. If the insurance coverage documentation is not submitted with application materials, proof of coverage must be submitted by the first day of the semester if a student is accepted to the program. Prospective students must secure their own coverage. Information on college student policies and rates can be found at https://www1.dcccd.edu/cat0608/ss/sd/insurance.cfm
. The National Student Nurses’ Association also partners with United Healthcare which offers a student policy for their members. See the following link for more information: https://www.uhcsr.com/NSNA
15. The Dallas County Community College District charges a higher tuition rate for courses in which a student registers for the third or more times. The “Third Attempt” policy includes credit courses taken at any of the
DCCCD colleges since Fall 2002. Developmental courses are not included in the Third Attempt Policy. For more information regarding the DCCCD “Third Attempt” policy, please visit the following website: http://www.dcccd.edu/ThirdCourseAttempt
16. A student may apply to more than one El Centro College Health Occupations program during a given filing period. However, if the student receives an acceptance letter to a specific program, confirms their intent to enter that program, and registers for program courses, their application to any other Health Occupations program that may share that filing period will be null and void.
Further, an individual accepted for admission and currently enrolled in an El Centro College Health
Occupations program may not apply or be considered for admission selection for another El Centro College
Health Occupations program unless their current program of study will complete before the second program curriculum begins. (Exception: An individual may apply to the Medical Laboratory Technology and
Biotechnology programs in tandem to complete that dual degree.)
Students should apply for Financial Aid Office well in advance of program application. More information on filing procedures and deadlines is found at http://www.elcentrocollege.edu/Student_Services/FinancialAid .
The Health/Legal Studies Office located in Room P-712 at 301 North Market Street also has information regarding scholarships and other financial assistance for health occupations students. Contact the Health and
Legal Studies Division at 972-860-5095 for more information.
18. Links to professional organizations and other information regarding the nursing profession can be found at: http://www.elcentrocollege.edu/Programs/HealthLegalStudies/adn/adnlinks.htm
.
Associate Degree Nursing (MHS)
16
Revised 06/01/12

19. Please contact the education office at your Methodist Health System facility or the individuals below for assistance (physical addresses):
RonChelle Kelly, MHS Nursing
Health Occupations Admissions Office
El Centro College/Paramount
301 North Market Street
Al Tolentino, B.A., M.A.
Liaison Counselor
Health/Legal Studies Division
E-mail:
Kimberly Griffith, MSN, RN, ACNP-BC
Education Specialist II
ECC/MHS AD Nursing Program
Methodist Health System
E-mail: kimberlygriffith@mhd.com
El Centro College/Paramount
301 North Market Street
Dallas, TX 75202
E-mail:
Telephone: 972-860-5045
Gary Peschka, M.Ed., R.R.T., R.C.P.
Health Occupations Faculty Advisor
El Centro College/Main Campus
College Counseling Center
801 Main Street
Dallas, TX 75202
Email: GPeschka@dcccd.edu
Telephone: 214-860-2039
Joan Becker, M.A., R.N.
El Centro College/Paramount
301 North Market Street
Dallas, TX 75202
E-mail:
Telephone: 972-860-5098
The official mailing address for all application materials, transcripts, and correspondence is:
RonChelle Kelly, MHS Nursing
El Centro College/Paramount
801 Main Street
Dallas TX 75202-3604
Associate Degree Nursing (MHS)
17
Revised 06/01/12

ESTIMATED EXPENSES FOR THE ASSOCIATE DEGREE NURSING PROGRAM AT METHODIST HEALTH
Primary Prerequisite Courses Tuition (15 cr. hrs.)
Secondary Prerequisite Course Tuition (14 cr. hrs.)
Textbooks, Lab Manuals
Physical Exam and Immunizations **
CPR Certification
HESI A
2
Entrance Test
Total
SEMESTER I
Tuition (Nursing courses – 8 cr. hrs.)
Nursing Textbooks
Nurse Pac (Skills Lab practice materials)
Exam Soft/ATI Testing Fees
Professional Liability Insurance***
Background Check/Drug Screen
Uniforms (approximate cost of 2 sets/lab coat)
Name Tag (2)
Shoes (approximate cost)
Stethoscope (approximate cost)
Bandage scissors (approximate cost)
Watch with second hand (approximate cost)
Total
SEMESTER II
Tuition (Nursing courses – 10 cr. hrs.)
Nursing Textbooks
Nurse Pac (Skills Lab practice materials)
Exam Soft/ATI and HESI Mid-Curr. Testing Fees
Total
SEMESTER III
Tuition (Nursing & humanities elec.-12 cr. hrs.)
Nursing Textbooks
Elective Course Textbook
Exam Soft/ATI testing fee
Nurse Pac (Skills Lab practice materials)
Professional Liability Insurance
CPR Recertification
Total
SEMESTER IV
Tuition (Nursing – 12 cr. hrs.)
Nursing Textbooks
Exam Soft/ATI and HESI Testing Fees
NCLEX-RN Application Fee
NCLEX-RN License Fee
NCLEX-RN Review Course (optional)
Total
TOTAL ESTIMATED PROGRAM EXPENSE
Resident
$ 675.00
630.00
Resident
$ 1,245.00
1,162.00
Country Resident
$ 1,980.00
1,848.00
1,550.00 1,550.00 1,550.00
225.00 225.00 225.00
65.00
35.00
$ 3,180.00
65.00
35.00
$ 4,282.00
65.00
35.00
$ 5,703.00
$ 360.00
1,100.00
32.00
191.50
18.13
86.00
$ 664.00
1,100.00
32.00
191.50
18.13
86.00
$ 1,056.00
1,100.00
32.00
191.50
18.13
86.00
120.00
20.00
60.00
35.00
8.00
40.00
$ 2,070.63
$ 450.00
473.00
104.00
251.00
$ 1,278.00
120.00
20.00
60.00
35.00
8.00
40.00
$ 2,374.63
$ 830.00
473.00
104.00
251.00
$ 1,658.00
120.00
20.00
60.00
35.00
8.00
40.00
$ 2,766.63
$ 2,148.00
$ 1,320.00
473.00
104.00
251.00
$ 540.00
150.00
90.00
229.00
30.00
18.13
35.00
$ 1,092.13
$ 540.00
75.00
544.00
200.00
139.00
60.00
$ 1,558.00
$ 9,178.76
$ 996.00
150.00
90.00
229.00
30.00
18.13
35.00
$ 1,548.13
$ 996.00
75.00
544.00
200.00
139.00
60.00
$ 2,014.00
$ 11,876.76
$ 1,584.00
150.00
90.00
229.00
30.00
18.13
35.00
$ 2,136.13
$ 1,584.00
75.00
544.00
200.00
139.00
60.00
$ 2,602.00
$ 15,355.76
* Tuition and other fees are subject to change. Please refer to current course schedule for tuition table.
** Estimated cost of physical exam and immunizations.
*** Liability insurance is assessed each fall at $18.13 to cover fall and spring semesters. Fee is prorated to $11.00 for spring entry.
See Accounting Office for Tuition Payment Plan option.
Other costs to consider: Transportation and Parking Fees to El Centro and hospital clinical sites, personal health care insurance coverage.
18
Associate Degree Nursing (MHS) Revised 06/01/12

.
10.
11.
6.
7.
8
NURSING APPLICATION CHECKLIST
This checklist is provided to assist you in following the steps toward program application.
1. _____ Obtain a nursing program information packet and attend an information session at a Methodist Health
System site.
2. _____ Complete a DCCCD application for college admission and see an academic counselor as needed for TSI counseling, placement testing, etc. and complete any developmental courses as may be prescribed from test scores.
3. _____ Submit official transcripts from all previously attended colleges and universities to El Centro College
Registrar’s Office or the Registrar/Admissions Office at any other DCCCD campus.
4. _____ If needed, request Educational Plan/transfer evaluation of course work taken outside the DCCCD that applies to Associate Degree Nursing curriculum with Health Occupations Admissions Office.
5. _____ Complete the following primary prerequisite courses:
_____ SCIT 1407 or BIOL 2401
_____ MATH 1314 or MATH 1414
_____ HPRS 1204
_____ In addition, complete the following secondary prerequisite courses:
_____ SCIT 1408 or BIOL 2402
_____ PSYC 2314
_____ Complete the humanities elective prior to application submission as time allows:
_____ Complete the HESI A
2
_____ BIOL 2420
_____ SPCH 1311 or SPCH 1315
, scoring a minimum of 70% on all required sections of the test.
_____ If time allows prior to an application filing deadline, complete any other additional courses which apply to the UTA Professional Nursing Pathways RN to BSN transition program (see list of courses on page 10 of this packet).
9. Compile the following materials as your complete nursing application packet and submit to RonChelle
Kelly in the Health Occupations Admissions Office at El Centro College (see Section F on pages 6-7 of this information packet for details and mailing address):
_____ Completed nursing application form (from this information packet).
_____ Signed Statement of Students’ Responsibility form (from this information packet).
_____ Photocopied catalog course descriptions for any courses taken outside the DCCCD which apply to the nursing curriculum.
score sheet indicating minimum scores of 70 on the five required sections of the test and the Personality Profile and Learning Styles section results.
_____ Physical Examination form/immunization documentation with CPR card photocopy attached.
_____ Copies of any request for course substitution forms (for evaluated transferred courses) or 5-year waiver forms that have been granted to the student.
_____ Send photocopies of all items listed on pages 8 & 9 to Kimberly Griffith at Methodist Health System
(mailing address on page 9) including documentation of personal healthcare insurance coverage.
Methodist Health System will make the final selection for the nursing class and notification letters will be mailed from the El Centro College Health Occupations Admissions Office.
19
Associate Degree Nursing (MHS) Revised 06/01/12

EL CENTRO COLLEGE
ASSOCIATE DEGREE NURSING PROGRAM AT METHODIST HEALTH SYSTEM
APPLICATION FORM
PLEASE PRINT:
SOCIAL SECURITY NO. __________/________/__________ DCCCD ID NO.
NAME
Last First MI Maiden/Other
ADDRESS
PHONE
City
Home
State
Cell/Other
Zip Code
EMAIL
HIGH SCHOOL GRADUATE? _____ Yes _____ No GED? _______ Yes _______ No
LIST ALL PREVIOUS COLLEGES ATTENDED FOR ACADEMIC CREDIT, INCLUDING ANY
DALLAS COUNTY COMMUNITY COLLEGES. (Do not abbreviate.)
DATE OF HIRE AT YOUR MHS FACILITY
I am submitting my application materials for admission to the
(Fall or Spring)
I certify that the information given on this application is complete and accurate.
Applicant’s Signature
20___ semester.
Date
Educational opportunities are offered by the Dallas County Community College District without regard to race, color, age, national origin, religion, sex, disability, or sexual orientation.
20
Associate Degree Nursing (MHS) Revised 06/01/12

STATEMENT OF STUDENTS’ RESPONSIBILITY
Review and initial each section as verification that you have read and understand this information:
_____ I acknowledge that this information packet contains policies, regulations, and procedures in existence at the time this publication went to press. I also acknowledge that the District Colleges including El Centro College reserve the right to make changes at any time to reflect current Board policies, administrative regulations and procedures, and applicable State and Federal regulations. Furthermore, I understand that this packet is for information purposes only and does not constitute a contract, expressed or implied, between any applicant, student, or faculty member and the Dallas County Community College District.
_____ I have read and understand the admission process for the Associate Degree Nursing Program at Methodist Health System (MHS) and acknowledge that it is a competitive selection process with a limited number of spaces available. I understand that successful completion of the nursing prerequisite courses, the required HESI A
2
test sections, and submission of complete application packet materials does not guarantee acceptance to the program.
_____ I understand that I must submit all of my current official transcripts (other than DCCCD transcripts) to the Registrar/Admissions Office at El Centro College or one of the other DCCCD campuses prior to applying to an El Centro College health occupations program and that failure to do so will void my application to the program.
____ I accept full responsibility for submitting a complete Associate Degree Nursing application packet prior to or by the designated application filing deadline and understand incomplete materials including missing or incomplete physical exam form, immunization records, and CPR certification documentation will disqualify my application.
I also accept the responsibility of informing the El Centro College Health Occupations Admissions Office of any change in my status, address, telephone number, or other information that would affect my application status.
_____ Although I may qualify as an applicant to the Associate Degree Nursing program at Methodist Health System, I acknowledge that MHS is responsible for making the final selection of those students who will be accepted into the Associate Degree Nursing Program at MHS and have my permission to review my grades. I acknowledge that Methodist Health System will determine to which MHS facility I may be assigned for clinical experience. I further acknowledge that a Social Security number is required to apply to the Associate Degree
Nursing Program at MHS. I am aware that if I am not selected for the MHS program, I may apply to the generic Associate Degree
Nursing Program offered at El Centro College and at the Northlake College extension program by following the application guidelines and application filing periods for that program.
_____ I understand that if accepted to a Health Occupations program, all physical examination forms, immunizations records, etc. submitted with my application packet becomes the property of the Health Occupations Admissions Office and will not be returned nor photocopied for me. Therefore, I take full responsibility for keeping photocopies of these documents for my own personal files before I submit them with program application packet materials. I also acknowledge that I am required to have my own personal health care insurance coverage and submit documented proof either with my application packet or, if I am accepted to the program, by the first day of class for the program.
_____ I am aware that I will be required to undergo a criminal background check and mandatory drug screening prior to being allowed to attend a clinical rotation. I understand that should I be prohibited from attending a clinical rotation at a clinical facility due to findings on my drug screen or criminal background check, I may be dismissed from the El Centro College Associate Degree Nursing program.
_____ I understand that the purpose of this program is to prepare me to write the NCLEX-RN licensing examination to become a registered nurse. In order to be eligible to write the exam, I must hold a high school diploma or a General Education Diploma (GED) certificate.
Furthermore, I must declare to the Texas Board of Nursing at least eighteen (18) months prior to program completion if I have ever been denied licensure by a licensing authority for nurses; had disciplinary action taken against me by a licensing/certifying authority; been convicted of a crime other than a minor traffic violation; am unable to safely practice professional nursing due to physical or mental disability/illness which may endanger the health and safety of persons under my care; been hospitalized or treated for chemical dependency within the past five years; am currently an intemperate user of drugs or alcohol; been issued a Declaratory Order by the
Texas Board of Nursing or ever taken the State Board Test Pool Examination, National Council Licensure Examination for Registered
Nurses, or the Canadian Nurses Association Testing Service Examination. If so, I must petition in writing and provide documentation to the Texas Board of Nursing for permission to take the NCLEX-RN examination, acknowledging that this review may take 12-24 months to complete and I will be assessed a fee by the Texas Board of Nursing.
Applicant’s Signature Date
21
Revised 06/01/12 Associate Degree Nursing (MHS)

El Centro College
Associate Degree Nursing Program at Methodist Health System
Profile Form
Please print:
Social Security Number: _____________/_____________/_____________ Date:
Name:
Address:
Last
Number & Street
First Middle/Other
Apartment Number
City State Zip Code
Phone:
Home Business Cell/Other
Email:
EMPLOYEE/VOLUNTEER/QUALIFYING FAMILY MEMBER HISTORY AT METHODIST HEALTH SYSTEM
Check:
Employee: _____ Volunteer: _____ Family member: _____ Qualifying Family Member Name:
Facility: ____ MDMC ____ MCMC ____ MMC ____MRMC ____ Corporate ____ Outreach ____ Other
Number of Years Employed: __________ years __________ months
Employment Status: ________ FT ________ PT ________ PRN Avg # Hrs worked per pay period
Manager:
DEADLINES FOR APPLICATION
Fall semester entry: January 1 – May 20
Spring semester entry: August 1 – October 20
Late filing deadline for Fall semester entry (if necessary): May 1 – July 15
Late filing deadline for Spring semester entry (if necessary): October 21 – December 20
Application submitted to El Centro? ________ Yes ________ No Date Submitted
Send this form to: Kimberly Griffith, MSN, RN, ACNP
Date
I certify that the information given on this Profile Form is complete and accurate. I have received a copy of the current criteria for acceptance to the el Centro College Associate Degree Nursing Program at Methodist Health System.
Applicant Signature
Methodist Health System
75265-5999
Associate Degree Nursing (MHS)
P.O. Box 655999
22
Revised 06/01/12